- Email: [email protected]
INTRAVASCULAR ULTRASOUND PREDICTORS OF MACROPHAGE ACCUMULATION AND INTRAPLAQUE HEMORRHAGE IN VULNERABLE PLAQUE
E1441 JACC April 5, 2011 Volume 57, Issue 15
VASCULAR DISEASE INTRAVASCULAR ULTRASOUND PREDICTORS OF MACROPHAGE ACCUMULATION AND INTRAPLAQUE HEMORRHAGE IN VULNERABLE PLAQUE ACC Poster Contributions Ernest N. Morial Convention Center, Hall F Sunday, April 03, 2011, 10:00 a.m.-11:15 a.m.
Session Title: Atherosclerotic Plaque Abstract Category: 8. Vascular Biology/Atherosclerosis/Thrombosis/Endothelium Session-Poster Board Number: 1008-109 Authors: Takao Sato, Tomoki Kameyama, Takahisa Noto, Teruo Nakadate, Hiroshi Ueno, Kunihiro Yamada, Hiroshi Inoue, University of Toyama, Toyama, Japan Background: Both macrophage infiltration and hemorrhage into coronary atheromatous plaque are associated with the development of vulnerable plaque. During percutaneous coronary intervention (PCI), mechanical plaque disruption exposes potentially embolic atheromatous contents from culprit plaque. Filter-based distal embolic protection device can retrieve this atherothrombotic debris. We investigated the relationship of macrophage accumulation and intraplaque hemorrhage to vulnerable plaque morphology evaluated by ultrasonic tissue characterization. Methods: In 26 patients with acute coronary syndrome, plaque burden and absolute and percentage of each plaque component (fibrous, fibrofatty, dense calcium (DC), and necrotic core (NC)) of culprit lesion were evaluated by virtual histology intravascular ultrasound (VHIVUS). Coronary atherothrombotic debris were collected during PCI using filter-based distal protection device, Filtrap (NIPRO, Japan). We immunohistochemically determined CD14- (proinflammatory macrophage marker) and CD163- (hemoglobin scavenger receptor, a marker of intraplaque hemorrhage) positive macrophages in the debris. Results: Total counts of CD14 cells had positive correlation with lumen(r=0.404, p<0.05), vessel (r=0.429, p<0.04) and plaque area (r=0.422, p<0.04) and remodeling index(RI, r=0.449, p<0.03). Similarly, total CD163 counts were correlated with lumen (r=0.433, p<0.04), vessel (r=0.488, p<0.02) and plaque area (r=0.461, p<0.03). Multiple regression analysis showed that CD14 counts correlated only with RI (p<0.03). Percentage of CD163 cells to whole cells (%CD163) showed positive correlation with remodeling index (r=0.402 p<0.05) and NC area (r=0.487 p<0.02) and negative correlation with DC area (r=-0.375, p=0.07), but percentage of CD14 cells had no correlation with IVUS parameters. Multiple regression analysis showed that %CD163 correlated positively with NC area and negatively with DC area. Conclusions: Positive remodeling is associated with macrophage infiltration into the plaque. Plaques with large necrotic core without calcification by VH-IVUS are related to intraplaque hemorrhage.
VASCULAR DISEASE INTRAVASCULAR ULTRASOUND PREDICTORS OF MACROPHAGE ACCUMULATION AND INTRAPLAQUE HEMORRHAGE IN VULNERABLE PLAQUE ACC Poster Contributions Ernest N. Morial Convention Center, Hall F Sunday, April 03, 2011, 10:00 a.m.-11:15 a.m.
Session Title: Atherosclerotic Plaque Abstract Category: 8. Vascular Biology/Atherosclerosis/Thrombosis/Endothelium Session-Poster Board Number: 1008-109 Authors: Takao Sato, Tomoki Kameyama, Takahisa Noto, Teruo Nakadate, Hiroshi Ueno, Kunihiro Yamada, Hiroshi Inoue, University of Toyama, Toyama, Japan Background: Both macrophage infiltration and hemorrhage into coronary atheromatous plaque are associated with the development of vulnerable plaque. During percutaneous coronary intervention (PCI), mechanical plaque disruption exposes potentially embolic atheromatous contents from culprit plaque. Filter-based distal embolic protection device can retrieve this atherothrombotic debris. We investigated the relationship of macrophage accumulation and intraplaque hemorrhage to vulnerable plaque morphology evaluated by ultrasonic tissue characterization. Methods: In 26 patients with acute coronary syndrome, plaque burden and absolute and percentage of each plaque component (fibrous, fibrofatty, dense calcium (DC), and necrotic core (NC)) of culprit lesion were evaluated by virtual histology intravascular ultrasound (VHIVUS). Coronary atherothrombotic debris were collected during PCI using filter-based distal protection device, Filtrap (NIPRO, Japan). We immunohistochemically determined CD14- (proinflammatory macrophage marker) and CD163- (hemoglobin scavenger receptor, a marker of intraplaque hemorrhage) positive macrophages in the debris. Results: Total counts of CD14 cells had positive correlation with lumen(r=0.404, p<0.05), vessel (r=0.429, p<0.04) and plaque area (r=0.422, p<0.04) and remodeling index(RI, r=0.449, p<0.03). Similarly, total CD163 counts were correlated with lumen (r=0.433, p<0.04), vessel (r=0.488, p<0.02) and plaque area (r=0.461, p<0.03). Multiple regression analysis showed that CD14 counts correlated only with RI (p<0.03). Percentage of CD163 cells to whole cells (%CD163) showed positive correlation with remodeling index (r=0.402 p<0.05) and NC area (r=0.487 p<0.02) and negative correlation with DC area (r=-0.375, p=0.07), but percentage of CD14 cells had no correlation with IVUS parameters. Multiple regression analysis showed that %CD163 correlated positively with NC area and negatively with DC area. Conclusions: Positive remodeling is associated with macrophage infiltration into the plaque. Plaques with large necrotic core without calcification by VH-IVUS are related to intraplaque hemorrhage.